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Risk Factors of Undernutrition Among Children Under 5 Years Old In 6th Asia-Pacific Conference on Public Health Supplement Risk Factors of Undernutrition Among Sarawak Pregnant Women re Iodine Children Under 5 Years Old in Jerantut, Deficient Despite Adequate Iodine Intake Pahang: A Case-Control Study Among School-Age Children Rafidah Binti Abdul Latif Lim Kuang Kuay, MSc, Tan Beng Chin, MSc, Chan Jerantut District Health Office, Ministry of Health Malaysia Ying Ying, MMedSc, Husniza Hussain, PhD, Nur Azna Mahmud, MSc, Mohd Shaiful Azlan Kassim, ABSTRACT MPH, Abdul Aziz Harith, MD, Cheong Siew Man, INTRODUCTION: There are nearly 815 million people MSc, Ruhaya Salleh, MSc, Tahir Aris, MPH who are chronically undernourished, which contributes to Institute for Public Health, Ministry of Health, Malaysia, Sarawak an estimated 3.1 million deaths annually. The National State Health Department, Ministry of Health, Malaysia Health and Morbidity Survey (NHMS) 2015 reported that ABSTRACT 8% of children suffer from undernutrition. In Jerantut, the prevalence of under-nutrition among children below the INTRODUCTION: The universal salt iodisation (USI) age of 5 was 5.67%. This study aims to determine the risk has been implemented to control the iodine deficiency factors associated with undernutrition among children disorders (IDD) in many countries. However, several below 5 years old in Jerantut, Pahang. METHODS: A studies conducted among school-age children (SAC) and case-control study design was conducted in March 2019. pregnant women (PW) found that adequate iodine status The case dealt with a child suffering from moderate to in SAC may not reflect adequate iodine status in PW. The severe undernutrition with a z-score < -2SD from the aim of this study was to assess the current iodine status median baseline recommended by World Health among SAC and PW after 10 years of USI in Sarawak. Organization (WHO) in 2017. The control patient in this METHODS: This cross-sectional survey among SAC and case study was a child without undernutrition, with z-score PW was conducted between July 2018 and October 2018. above -2SD. Secondary data from the antenatal book and A proportion to population size sampling technique was children’s health records were used. Multivariate logistic used to select 30 schools and 30 maternal and child regression analysis was conducted using SPSS 25.0 for healthcare clinics. A total of 1200 SAC and 750 PW were Windows. RESULTS: A total of 226 respondents randomly selected to participate in the study. Thyroid size amounting to 113 cases and 113 controls were selected. It and urinary iodine concentration (UIC) level was was found that risk of undernutrition was significantly classified according to the WHO/UNICEF/ICCIDD associated with low household income (aOR: 6.52, assessment criteria. RESULTS: A total of 988 SAC and 95%CI: 1.81, 23.53), low birth weight (aOR: 6.25, 677 PW participated in the study with response rates of 95%CI: 1.17, 33.30), recurrent illness for acute 82.3% and 90.2%, respectively. The total goitre rate gastroenteritis (AGE) (aOR: 3.32, 95%CI: 1.07, 10.27) (TGR) was found to be 0.1% in SAC and 1.0% in PW. The and for upper respiratory tract infection(URTI) (aOR: overall median UIC level among the SAC was 126.0µg/L 6.05, 95%CI: 3.06, 11.94). The daily consumption of (IQR: 71.0, 200.9µg/L), classified as adequate iodine fruits or vegetables is a protective factor for undernutrition intake, while the median UIC among PW was 123.9µg/L (aOR: 0.48, 95%CI: 0.25, 0.92). CONCLUSION: Low (IQR: 56.5, 192.1µg/L), classified as insufficient. birth weight, low household income, recurrent AGE and CONCLUSION: The present findings indicate that URTI were noted as significant risk factors associated despite adequate iodine intake in SAC, the majority of PW with undernutrition. Daily consumption of fruits or still showed insufficient iodine intake. Thus, a vegetables is a protective factor for undernutrition. comprehensive monitoring of the IDD among PW and appropriate nutrition education is warranted KEYWORDS: Undernutrition, PPKZM, Risk Factors, Jerantut KEYWORDS: universal salt iodisation, school-age children, pregnant women, Sarawak 42 Med J Malaysia Vol 74 Supplement 2 Aug 2019 .
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